Sunday, August 24, 2008

The 12,000 Iron Ingot Diet

Now that Michael Phelps and the Olympics are finally over, we can get back to the really important stuff like, "So when am I going to die?" I am reminded of an event that took place several months ago when a member of my ward had an episode that prostrated him on the floor of the bathroom. I arrived shortly after the paramedics did and we gave the fellow a blessing. The frantic wife, after the blessing, asked me imploringly, "Is my husband going to die?" I said "Yes..... But probably not today." Trillium found this piece of unveiled humor particularly macabre and thought that I ought to avoid it in the future. I have been moderately successful, but I am having some difficulty pulling it off on this blog.

As I have indicated before, the treatment, if not the cure, for hemochromatosis is phlebotomies, or "blood-letting". The recommendation is to take a pint or two for several weeks until the ferritin level drops to almost the "anemic" level, and then draw a pint about once a quarter thereafter. As the body regenerates the new blood, it looks around for stored iron in order to make the blood capable of carrying the oxygen to all the tissue in the body. Iron binds with oxygen and releases the oxygen once it arrives at the proper locations. Without iron, the oxygen could not be carried about easily. Iron-overloading, as it turns out, does little to provide more oxygen. Getting back to my point; it is the creation of new blood that requires more iron. The more blood that is drawn, the more the body has to draw on those stored iron molecules. After a while, most of the stored iron is extracted and tissues like the kidneys, the liver, and the pancreas return to normal. So, the patient has the blood drawn, drinks vast amounts of fluids (preferably not Mountain Dew, Chris), and then waits upon nature to deliver him from the normal effects of hemochromatosis. Typically, the drawing of a pint of blood reduces the ferritin level by 40 or 50 points. Inasmuch as my ferritin level was (perhaps is) at 827, I would need to have about 16 pints of blood drawn. This works out to about four months of treatment by following the recommended technique. Some physicians recommend two pints a week; at that rate I would be at a normal ferritin level in about eight weeks. There are obviously far more radical treatments possible, but the chances of survival begin to wane considerably.

In conjunction with phlebotomies, the standard treatment also encourages improved eating habits. Red meat is discouraged, wiping out such delicacies as rack of beef ribs, tri-tip steak, any $6.00 burger, anything from the Sizzler menu, liver, beef tongue, kidney pie, blood sausage, menudo, chicken feet, flank of horse, seal flippers, and any more than six ounces of whale blubber at a time. In the spirit of the appropriate diet for my condition, I decided to exclude the last nine items from my repasts.

Oddly enough, taking over-the-counter vitamin C tablets is discouraged, the reason being that vitamin C facilitates the absorption of non-heme iron. Thus, if I were to consume the "Green Drink" with 2000 or 3000 units of vitamin C (which I have done on occasion), it would be tantamount to injecting 20 ounces of bacon fat into my jugular vein. So, as a result, my morning ritual of pill popping has been simplified by one letter of the alphabet. Also, vitamin C will cause the heart to store abnormal amounts of iron, causing a rather irksome "clanking" sound every time there should be a tender "thump". Finally, the vitamin C will facilitate the storage of iron in the joints, welding the bones together with arthritis, causing further "clanks", "clunks", and "squeaks". Needless to say this can be unnerving to anyone within a seven-block radius.

Sushi is a "no-no"; a real heart-breaker that! A hemochromatosis patient should not even handle raw seafood. While this allows me to scurry out of the kitchen whenever the halibut appears, there is another downside to this particular problem. I can no longer walk on the beach barefoot. There is in sea water a bacteria called "Vibrio vulnificus" which, when it encounters stored iron is catastrophically toxic. Never mind about the Great White out there just beyond the breakwater; that big toothy guy is part of the treatment. Imagine, one bite and Wow!, a whole bunch of stored iron instantaneously gone, with aggravated phlebotomies as a chaser. Some things just seem counter intuitive.

Green tea inhibits absorption of iron of any kind. It is the tannin in tea that does the trick. Green Tea HP, a single cup of which is equal to 52 cups of regular tea, will dissolve an Abrams tank in fifteen minutes, so think what it would do to the stored iron in your body. Patients must understand that this will not be a replacement for protocol treatments, but will provide some entertainment value for the the nurse assigned to the task of taking your blood. How much fun would it be to draw a pint from a highly agitated moving target with a 14-gauge needle? It provides sufficient inducement for acquiring a stun-gun with 15 ccs of Demerol, I'll tell you.

So, with all of this information before me, how is that the day after I had my first pint drawn that I found myself at the home of Barbara and Jay eating a half-pound of tri-tip steak? Barbara had invited Trillium and I to their place because of some service that we and several neighbors had rendered to them. I was asked to grill the meat, which I did. Grilling ten pounds of tri-tip will disorient anyone, regardless of the diseases with which they may or may not be afflicted. I considered marinating the meat in Green Tea HP, but thought that B-J really wanted to have a subdued get-together.

Last Friday, suffering from an extreme case of cabin-fever, I invited Trillium to lunch. We decided to go to Kneaders, a place where the sandwiches are completely iron-free, so long as you eat only the lettuce and avoid the lemonade. BYU was in the midst of Education Week and the place was packed. We left without parking. "Where shall we go? Trillium asked. I said that there was another Kneaders in north Orem. As we pulled back onto Bulldog Avenue (named for the mascot of Provo High School) she said, "How about there?" Like Pavlov's dog, I started drooling. "You mean it? (slurp, slurp)" "Sure. What would you have if we ate here?" I knew that this was a test. I thought for a nanosecond and replied, "I would have the $6.00 Guacamole Bacon Burger, with fries and a lemonade (clank, clunk, squeak)". I really said that as a joke, thinking that I would have something else less ferrous. I could not resist, however, when it came time to order. After I took my first bite, I began to feel faint; my head was swimming, Trillium thought that I was having a stroke. "What's wrong with you?" she queried. "Twenty ounces of bacon fat!" I gasped. Trillium looked a little frantic, "Is my husband going to die?" "Yes," I said,".... but probably not today."


Trillium said...

Here she comes now: the obnoxious "the truth IS" know-it-all. The truth is vitamin C absorbs heme iron too. I realize that this bit of information doesn't help your joke along. The second truth is that you have a sentence up there that uses an "I" when you should have used a "me". A guy with so many degrees in English needs to set the right example--even if he is "dying." :D

Zaphod said...

It would appear that I have absorbed a couple of pieces of shrapnel here. However, if considered rightly, there is, once again, no harm no foul. First, out of consideration for my readers who bitterly complain about how long and torturous my little blog pieces are, I attempted be be somewhat terse in this entry. It is quite true that vitamin C does facilitate the absorption of both heme and non-heme iron, but the heme iron was not part of the joke. My jokes are crowded enough as it is, with twists and turns, polylingual innuendoes and such, without introducing another whole character.

Secondly,in the seventh paragraph (second from the bottom) the phrase "Trillium and I" does appear to have a nominative case pronoun in a location demanding the objective case (one of the direct objects of the verb "invited"). However, you will notice that "Barabara and Jay" are reduced to "B-J" later in the paragraph. Is it not just a possibility that the "I" is also an abbreviation for ...... "Ironman"? So let it be written, so let it be done.

Anonymous said...

I was laughing so hard that I spewed whale blubber all over my monitor! I find it quite refreshing in the morning..cold and jiggly..yum! I use chicken feet as a scoop for it. I don't find your blog entries torturous! I actually get impatient with blog entries that are short. It's like "hey! if you aren't going to put in any effort, don't do anything at all!"

Anonymous said...

By the way, that McDonald's song was HILARIOUS! I had to turn it off because I was laughing so hard. I found it rather fitting fo you. :D

Katscratchme said...

You know Dad, I was thinking that it might do you some good to take Mom's critisism with good grace and not try to make it seem like you made a mistake on purpose.. but then I thought.. where would I get my daily head-shaking neck-cricking adjustment if you weren't making things up all the time?

Just an addition to Dara's comment about the music.. I have yet to listen to the Marvin the Paranoid Android song in entirety because it's so distracting while I'm trying to read your blog. I'm torn in two directions so I have to chose your blog and turn off the music.. sigh.. one day I'll listen to it completely.

Rebecca said...

This was funny. I was laughing so hard my kids tried to crowd in around the monitor. Asking: "What's so funny?" The only thing I could say was grandpa! With the current health conditions; addictions and ailments of this family, we should all check-in to an herbal de-tox facility and have a family reunion.